Physician
Carelon Medical Partners of North Carolina PC
Carelon Medical Partners of North Carolina PC was paid $398K by Medicaid between Jan 2023 and Dec 2024, across 18 billing codes. Its largest line is 99199, Unlisted special service, procedure or report — 94% of everything it billed.
33Billing provider infoCARELON MEDICAL PARTNERS OF NORTH CAROLINA PC
RALEIGH, NC 27610
RALEIGH, NC 27610
33aNPI1659775831assigned 10/16/2014
33bProvider typeHospice and Palliative Medicine (Internal Medicine) Physician
28Total paid$398K
24GClaims141,787
24DCodes billed18
24AFirst – last monthJan 2023 – Dec 2024
Compared with peers
Next to other Hospice and Palliative Medicine (Internal Medicine) Physician providers in North Carolina
Rank by total paid#1 of 16
Median peer was paid$9K
This provider vs. median43×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2023 | 71,580 | $201K | |
| 2024incomplete | 70,207 | $196K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99199 | Unlisted special service, procedure or report | 94% | 133,878 | 133,873 | $375K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.6% | 4,329 | 2,645 | $10K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 2.1% | 1,914 | 1,199 | $8K |
| 99442 | <1% | 414 | 218 | $2K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 226 | 200 | $776.56 |
| 99385 | <1% | 142 | 93 | $665.58 | |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 15 | 15 | $545.47 |
| 99443 | <1% | 30 | 30 | $276.96 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 242 | 224 | $72.90 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 93 | 75 | $66.50 |
| 99441 | <1% | 28 | 27 | $28.84 | |
| 94760 | <1% | 25 | 12 | $4.14 |
6 more codes
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialALBION, TIMOTHY (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Albion Medical Group of Nevada, PC | Las Vegas, NV | $268K |
| Carelon Medical Partners of Arizona PC | Des Moines, IA | $7K |
| Carelon Medical Partners, PC | Nashville, TN | $5K |
| Carelon Medical Partners of Texas PA | Houston, TX | $139.76 |
| Carelon Medical Partners of Arizona, P.C. | Tucson, AZ | $0.00 |
| Albion Medical Partners of California, PC | Pasadena, CA | $0.00 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.